| NPI | 1104548049 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARBARA LESLIE Administrator 770-314-3377 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 101YP1600X Counselor, Pastoral |
| 251S00000X | |
| Enumeration Date | 2022-09-16 |
| Last Update Date | 2022-09-16 |